Healthcare Provider Details

I. General information

NPI: 1225195332
Provider Name (Legal Business Name): QUALITY CARE PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 10/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 662 CALLE MARGINAL BO. SANTANA
ARECIBO PR
00612
US

IV. Provider business mailing address

PO BOX 967
BAJADERO PR
00616-0967
US

V. Phone/Fax

Practice location:
  • Phone: 787-881-7872
  • Fax: 787-880-9066
Mailing address:
  • Phone: 787-881-7872
  • Fax: 787-880-9066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number17-F-2948
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NELSON CAMACHO
Title or Position: OWNER
Credential:
Phone: 787-424-3913